Anti Thyroperoxidase Antibody (Anti-TPO) Test

Subclinical hypothyroidism, Goitre, Hyperthyroidism, Thyroid Cancer, Hashimoto disease, Graves’ disease

There is a small gland in our body located in front of the neck. This gland is the thyroid gland. It is a vital part of our body and controls various factors of our body such as influencing metabolism, growth and development and body temperature. During infancy and childhood, adequate thyroid hormone is crucial for brain development.

Our immune system creates antibodies to fight harmful foreign organisms such as bacteria and viruses. But in some cases, the antibodies mistake the healthy cells for foreign substances and start attacking them. This leads to autoimmune diseases.

Thyroid antibodies are the reason anti-TPO tests are done. Thyroid antibodies can be formed inside a human’s body when the immune system malfunctions and starts targeting the thyroid gland and its proteins. Various types of thyroid antibodies affect the thyroid gland in different ways. Anti-TPO stops TPO from using iodine which leads to hypothyroidism. This also leads to inflammation that can damage the thyroid gland partly or fully.

Thyroid peroxidase is an enzyme produced in the thyroid gland. TPO plays an important role in the production of thyroid hormones. The anti-TPO test is done to diagnose the level of antibodies against TPO. These antibodies are responsible for causing Hashimoto's disease and Graves’ disease.

An anti-TPO test is used to detect the antibody levels in the blood of the patient. This test is ordered by the physician when the patient exhibits symptoms of hypothyroidism or hyperthyroidism. The results of the anti-TPO test help in pointing out which hormone antibodies of the thyroid gland are affecting the body.

Thyroid disorders are common in India due to the lack of proper nutrition for a majority of the population. The lack of iodine can cause the thyroid gland to not work as it should. This can lead to deficiency diseases such as goitre and hypothyroidism.

Other names of anti-TPO test

• Hashimoto disease test
• ATPO
• Thyroid peroxidase test
• TPO

What does the anti-TPO test measure and who is this prescribed for?

The anti-TPO test measures the concentration of anti-TPO in the bloodstream. This test is prescribed for people with the following symptoms:

• Fatigue and sluggishness
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Brittle nails
• Hair loss
• Enlargement of the tongue
• Depression
• Memory lapses
• Unexplained weight gain
• Muscle aches, tenderness and stiffness
• Joint pain and stiffness
• Muscle weakness

Because of the above-mentioned symptoms, the doctor might prescribe an anti-TPO test. The following diseases are majorly related to anti-TPO:

• Goitre
• Subclinical hypothyroidism
• Graves’ disease
• Hashimoto disease
• Thyroid cancer

Following the specific tests regarding the different antibodies, the physician or endocrinologist can pinpoint the cause of the problem and administer appropriate treatment. Pregnant women are also advised to take this test to safeguard their health as well as the unborn baby.

What happens when anti-TPO is high?

TPO uses iodine to produce thyroid hormones in the thyroid gland. Having a high anti-TPO can lead to autoimmune diseases such as Hashimoto’s disease and Graves’ disease. You should consult a doctor when you experience the following symptoms:

• Tiredness for no apparent reason
• Dry skin
• Pale, puffy face
• Constipation
• Increased sensitivity to cold
• Brittle nails
• Hair loss
• Enlargement of the tongue
• Depression
• Excessive or prolonged menstrual bleeding
• Muscle aches, tenderness and stiffness
• Muscle weakness

If you have the above-mentioned symptoms, the doctor might warrant an anti-TPO test.

How do I lower my anti-TPO?

Anti-TPO levels can be lowered through changes in diet and lifestyle as medications can only do so much. Lifestyle and diet changes can reduce inflammation of the thyroid gland, slow down or prevent damage caused by high anti-TPO, and manage blood sugar, weight and cholesterol levels. The following diets are usually suggested by specialists:

• Gluten and grain-free diets - In this diet, you have to cut out gluten or grains from your daily consumption. A gluten-free diet is considered beneficial by doctors, although research supporting it is still limited.
• Anti-inflammatory foods - Inflammation is the most prominent symptom of high anti-TPO and can also worsen your condition. Consuming an anti-inflammatory diet consisting of foods and vegetables can significantly relieve your symptoms.

How do you treat high anti-TPO?

High anti-TPO levels lead to autoimmune diseases such as Hashimoto’s thyroiditis. Conditions like Hashimoto’s thyroiditis are incurable. But it can be managed and controlled through the following ways:

• Thyroid hormone medication can be used to replace the hormones that the thyroid made before the escalation of anti-TPO.
• Medication is prescribed by the endocrinologist to maintain the hormone levels of the thyroid gland within the normal range.
• Changes in daily diet and lifestyle can have a huge impact on the management of anti-TPO levels. Cutting out anti-inflammatory food items and replacing them with fruits and vegetables can relieve the thyroid gland and ease the inflammation inside the body.

The anti-TPO test results show the concentration of antibodies in the bloodstream. If the value is within the normal range, i.e., less than 9 IU/ml, the chances of having an autoimmune disease related to TPO are less. But values above 9 IU/ml are an indication of autoimmune thyroiditis. Anti-TPO levels can also be on the higher side due to other autoimmune diseases.

The results of the anti-TPO test can also be divided and explained into positive and negative:

• Negative - Negative means the absence of antibodies against thyroid peroxidase. This means if the patient has symptoms of autoimmune diseases, it is probably not related to TPO.
• Positive - Positive means high levels of anti-TPO found in the blood. This means the patient may have Hashimoto’s disease or Graves’ disease.

The higher the concentration of anti-TPO, the more likely it is that the patient has an autoimmune disease of the thyroid gland. Thyroid diseases tend to get worse during pregnancy and they can harm the mother as well as the foetus. If the mother has ever had thyroid disease, she will be tested for anti-TPO, along with other thyroid antibodies.

The anti-TPO test is a simple blood test. A blood sample is collected from the arm's vein.

Test Preparation

Before the test

No special precautions are required to be taken before the test. If the patient has a medical history or is undergoing medical treatment for any other disease, it is advisable to inform the physician about it.

During the test

The test is a simple blood test. A medical professional will tie a strap tightly around the arm and extract the required amount of blood from the vein. The procedure has little to no risk and takes less than 5 minutes.

After the test

After the sample is taken, the point from where the blood was extracted is covered with a swab of cotton to prevent bleeding. There are no post-test restrictions. Normal activities can be resumed.

Test inclusions: What parameters are included?

The anti–TPO test diagnoses the levels of antibodies against the thyroid peroxidase enzyme. The values indicate the presence of anti-TPO and the concentration in the blood. The test can be complex to interpret, so the best option is to consult with a specialist. In the presence of Hashimoto’s thyroiditis, the result of the anti–TPO test will be on the higher side. The same goes for patients with Graves’ disease.

How frequently should you take this test?

There is no fixed time interval during which the anti-TPO test is done. In the presence of symptoms of autoimmune diseases such as Hashimoto disease and Graves’ disease, the physician might prescribe an anti-TPO test along with other tests to get an accurate idea of the cause of the issue. The test can help diagnose whether the root of the problem is related to thyroid peroxidase or other hormones of the thyroid gland.

Depending on the city and the lab, the cost of an Anti-TPO test can differ. Generally, the price for an Anti-TPO test ranges from INR 825 to INR 1539. Here's a breakdown of the average expenses for an Anti-TPO test in several key cities in India: